Saturday 2 April 2016

Response to nivolumab (PD-1 antibody) in hypermutated glioblastoma

Click here for the abstract

Treatment of two siblings with multifocal, hypermutated GBM resulting from "biallelic mismatch repair deficiency" leads to "clinically significant responses and a profound radiologic response."

Find the full paper in the Library.

5 comments:

  1. This is great Stephen. Thanks for sharing. The problem is whether the response will continue to be durable or will be short lived.. I am also wondering if there is a difference between the response in Nicolumab and keytruda.. Somehow I am seeing better responses with Nivolumab even though they are supposed to be the same thing.

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  2. I discussed the difference between keytruda and Nivo with my sons NO Friday. It is his belief they will provide the same efficacy, but that is just an opinion. No proof yet. He did say those that are funding the drug themselves, Nivo has a maximum income restriction and keytruda does not. So for those making more than what you are allowed with Nivo, you might check out keytruda.

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  3. Thanks Michael. This is what my husband's NO mentioned too. I would be interested to see how those Pd-1 inhibitors act with vaccines. It is great knowing they worked alone in combined with other chemo agents or immunotherapies in those 2 kids.. Time will tell if this was an anomaly or whether there is a subgroup may be in GBM s that would respond to the PD-1s. My understanding is that all initial trials have given an indication that Pd-1 on their own might not be enough in GBM.

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  4. There is information out of Duke showing in rGBM's a 40% one year survival with Nivo alone, vs 26% with SOC. Sorry I am at work and do not have the link. I also wonder if the PD-1 inhibitors might work better with supplements such as PSK, Maitake D Fraction, or if they might increase the change of side effects.

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  5. Nivo seems to be performing better across trials, while this might relate to patient selection it could be a difference between each drug. Both are antibodies that target PD-1; however, antibodie can have different binding efficiency. Nivo might be a little better, but there isn't much difference. Thanks for this paper it's a good one.

    Noha, one thing this paper drives at is selection. Patients with a high number of genetic alterations are better candidates for these drugs. Combination approaches such as radiation are looking good for melanoma. For pancreatic cancer, vaccines activate PD-L1 in a portion of patients, so those look good for combos.

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